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General NPI Number Information
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NPI Number | 1518030717
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Entity Type | Individual
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Provider Name | MARK JOSEPH MCBRIDE MD
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Gender | Male
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Dates
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Enumeration Date | 11/16/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1611 NW 12TH AVE
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City | MIAMI
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State | FL
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Zip | 33136-1005
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Country | US
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Telephone | 305-585-6913
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Fax |
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Provider Business Mailing Address
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Address Line | 3301 NE 5TH AVE APT 1215
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City | MIAMI
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State | FL
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Zip | 33137-4053
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Country | US
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Telephone | 305-573-7474
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | ME54660
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License Number State | FL
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